- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00753233
Identification of Risk Factors for Arrhythmia in Children and Adolescents With Hypertrophic Cardiomyopathy
Long Term Follow Up of Children and Adolescents Diagnosed With Hypertrophic Cardiomyopathy: Identification of Risk Factors That Predict Arrhythmia Events
This study will review medical information collected on children and adolescents with hypertrophic cardiomyopathy (HCM) to try to identify risk factors for arrhythmias (abnormal heart rhythms) in these patients and better guide the choice of treatment options for them. Arrhythmias arising from the ventricle (lower heart chamber) can cause dizziness, fainting or cardiac arrest. Predictors of arrhythmias in adult HCM patients may not apply to children and teenagers with HCM.
Children and adolescents 21 years of age or younger who were diagnosed with HCM and evaluated in the National Heart Lung and Blood Institute's Cardiology Branch between 1977 and 2002 may be eligible for this study.
Participants do not undergo any further testing or data gathering beyond a review of their medical records; only existing data previously collected for research purposes are used. Medical records are reviewed for age of the patient on admission to the NIH; family history of sudden death, fainting, exercise-induced low blood pressure, and results of tests on heart structure and function.
Study Overview
Status
Conditions
Detailed Description
Patients with HCM have an increased incidence of sudden death, particularly younger individuals. However, HCM has markedly variable clinical presentations, and the risk of sudden death and arrhythmia events (AE) differs significantly from one patient to another. Several risk factors for AE have been proposed. These risk factors have been defined in predominantly adult HCM populations. Little data is available defining risk factors for sudden death in a carefully defined HCM population composed of only children and adolescents. Those at highest risk may benefit from implantable defibrillator (ICD) therapy. However, the universal application of ICD therapy is not without significant morbidity and mortality.
Traditional risk factors for sudden death (SD) in adult HCM patients include a family history of SD, young age, non-sustained ventricular tachycardia (VT) on Holter monitoring, increased ventricular septal thickness (ST), abnormal blood pressure (BP) response to exercise and syncope.
The purpose of this study will be to 1) to determine whether risk factors for and mechanisms of AE in adults have predictive value in children, and 2) in particular, whether ventricular septal thickness and inducible ventricular tachycardia at electrophysiologic study (EPS) would identify a subgroup of children that might benefit most from ICD implantation.
Clinical features that will be examined as potential AE predictors included: age at presentation to the NIH; family history of SD; pre-syncope or syncope; exercise-induced hypotension; ventricular septal thickness; LV outflow obstruction; elevated LV end diastolic pressure; QRS duration; QT interval; VT on ambulatory electrocardiographic monitoring; myocardial ischemia on stress nuclear perfusion imaging; inducible VT; intra-cardiac conduction intervals; and ventricular refractory periods. Statistical significance for the time-to-event analyses will be assessed using the logrank statistic for dichotomous variables and Cox's score statistic for continuous variables.
We anticipate that this study will improve risk stratification in children and adolescents with HCM, enhance our ability to predict AE, and refine guidelines for ICD therapy in children.
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
-
-
Maryland
-
Bethesda, Maryland, United States, 20892
- National Heart, Lung and Blood Institute (NHLBI), 9000 Rockville Pike
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
- Children and adolescents (less than or equal to 21 years) with HCM who had been evaluated in the Cardiology Branch, National Heart Lung and Blood Institute between 1977 and 2002. HCM was diagnosed by echocardiographic demonstration of a hypertrophied non-dilated left ventricle (LV) in the absence of another cause of LV hypertrophy. All patients participated in protocols approved by the NHLBI Institutional Review Board, and provided informed written consent to participate. The patients participated in the following protocols: 98-H-0102, 77-H-0082, 99-H-0150, 01-H-0007, 96-H-0144, 94-H-0001, 84-H-0232, 98-H-0100, and 99-H-0065.
Study Plan
How is the study designed?
Design Details
Collaborators and Investigators
Publications and helpful links
General Publications
- Colan SD, Lipshultz SE, Lowe AM, Sleeper LA, Messere J, Cox GF, Lurie PR, Orav EJ, Towbin JA. Epidemiology and cause-specific outcome of hypertrophic cardiomyopathy in children: findings from the Pediatric Cardiomyopathy Registry. Circulation. 2007 Feb 13;115(6):773-81. doi: 10.1161/CIRCULATIONAHA.106.621185. Epub 2007 Jan 29.
- Frenneaux MP. Assessing the risk of sudden cardiac death in a patient with hypertrophic cardiomyopathy. Heart. 2004 May;90(5):570-5. doi: 10.1136/hrt.2003.020529. No abstract available.
- Maron BJ, Shen WK, Link MS, Epstein AE, Almquist AK, Daubert JP, Bardy GH, Favale S, Rea RF, Boriani G, Estes NA 3rd, Spirito P. Efficacy of implantable cardioverter-defibrillators for the prevention of sudden death in patients with hypertrophic cardiomyopathy. N Engl J Med. 2000 Feb 10;342(6):365-73. doi: 10.1056/NEJM200002103420601.
Study record dates
Study Major Dates
Study Start
Study Completion
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 080210
- 08-H-0210
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Hypertrophic Cardiomyopathy (HCM)
-
CytokineticsEnrolling by invitationSymptomatic Hypertrophic Cardiomyopathy (HCM)United States, France, Israel, Spain, United Kingdom, Italy, Poland, Hungary, Denmark, Netherlands, Germany, Czechia, Portugal
-
Guangdong Provincial People's HospitalRecruitingHCM - Hypertrophic CardiomyopathyChina
-
CytokineticsCompletedHypertrophic Cardiomyopathy (HCM)United States, Spain, Italy, Netherlands
-
IRCCS San RaffaeleMenarini International Operations Luxembourg SACompletedHCM - Hypertrophic Non-Obstructive CardiomyopathyItaly
-
Thibaud DamyCompletedCardiac Amyloidosis | Hypertrophic Cardiomyopathy (HCM) | Amyloidosis in Transthyretin (TTR)France
-
University Hospital HeidelbergCharite University, Berlin, Germany; Goethe University; University Medicine Greifswald and other collaboratorsRecruitingAmyloidosis | HCM - Hypertrophic Cardiomyopathy | Arrhythmogenic Right Ventricular Cardiomyopathy | Inflammatory Cardiomyopathy | DCM - Dilated Cardiomyopathy | Non-ischemic Cardiomyopathy | HOCM - Hypertrophic Obstructive Cardiomyopathy | Left Ventricular Noncompaction CardiomyopathyGermany
-
French Cardiology SocietyCompleted1- Primary (Sarcomeric) Hypertrophic Cardiomyopathy | 2- Obstructive Hypertrophic Cardiomyopathy | 3- Non Obstructive Hypertrophic CardiomyopathyFrance
-
Montreal Heart InstituteCanadian Institutes of Health Research (CIHR)Enrolling by invitationCardiomyopathies | Hypertrophic Cardiomyopathy | Hypertrophic Obstructive Cardiomyopathy | Familial Hypertrophic CardiomyopathyCanada
-
University of Sao PauloCompletedNon-obstructive Hypertrophic Cardiomyopathy | Obstructive Hypertrophic CardiomyopathyBrazil
-
Bristol-Myers SquibbActive, not recruitingHypertrophic Cardiomyopathy | Non-obstructive Hypertrophic Cardiomyopathy | Obstructive Hypertrophic CardiomyopathyDenmark, United States, Belgium, Czechia, France, Germany, Israel, Italy, Netherlands, Poland, Portugal, Spain, United Kingdom